Poison Control Chart: Cannabis vs. Alcohol

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The number of cannabis-related calls to California’s poison control centers has spiked in recent years, and it appears that this year—the first full year of legal sales to adults in the state—will see the biggest jump yet, according to the California Poison Control System.

That’s no surprise. Under legalization, citizens are more honest about cannabis exposures. And as sales of cannabis products grow, so too do the chances that kids, in particular, will accidentally ingest edibles. There’s just more of the stuff around, and parents can be careless.

But perspective is key.

First, while it can be frightening and even terrifying, especially to a small child, to suddenly start feeling cannabis’ effects while having no idea what’s happening, no fatalities or long-term harms seem to have been reported.

And second, though the spike in cannabis-related calls to poison control might seem striking, the numbers are dwarfed by the number of reports related to other substances that will kill you, like aspirin and household chemicals. Calls related to kids ingesting cannabis number in the hundreds per year—in a state of 38 million. Calls related so other substances tend to be in the thousands or tens of thousands.

That didn’t stop the Los Angeles Times from publishing a context-free July scare story bearing the headline, “More California kids are having pot-related health scares, poison control officials warn.” The article declared that “state and local officials say they are alarmed” by the increase in calls related to kids and teens ingesting cannabis.

Only one state official was quoted, though, and going by what he told Leafly, he seems more “concerned” than “alarmed.”

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Comparatively Few Cannabis Calls


That official is Dr. Stuart Heard, executive director of the California Poison Control System, which is run out of the University of California San Francisco. His concern is well placed.

Cannabis, he noted, “is not all that harmful, but it’s not harmless.”

If a 4-year-old boy eats a bunch of THC-loaded gummies, he’s going to freak out. That’s a harm, even if it’s not a catastrophic one. If a young girl eats a pot-laced doughnut, her heart might start racing, and she might become dizzy and nauseated. Such symptoms, Heard agreed, might be due to the stress of not knowing what’s happening more than to any direct effects of cannabis.

Poison Control reports that the number of calls to poison control centers in California involving cannabis ingestion in people 19 and younger rose from 347 in 2015 to 588 in 2017, when it became legal for adults to possess pot. About half of those calls involved kids ages five and under.

For the first six months of 2018—the first year of legal retail sales to all adults—there were 386 calls involving people 19 and under. If that trend were to continue for the rest of the year, the number would be 772. That would be more than double the calls in 2015. But in the context of calls involving other substances, it’s nothing.

Compared to the number of calls about other stuff, there are not a lot of calls about cannabis.
Dr. Stuart Heard, Executive Director of the California Poison Control System

For example, Heard told Leafly, there were 15,545 calls to poison control centers in 2017 involving ingestion of analgesics (aspirin, Tylenol, Advil, etc.) by people 19 and younger. About 9,339 children ages five and below got into the stuff last year in California. And there were 11,704 calls to report ingestion of household cleaning products by people 19 and younger, with 10,091 of those involving kids ages five and below.

Besides the sheer numbers, there’s another major difference between those substances and cannabis: They can seriously injure or kill a person, while cannabis cannot.

Not Really a Poison

Which is not to say accidental cannabis ingestion isn’t a problem. It clearly is. And yet, Heard said, “compared to the number of calls about other stuff, there are not a lot of calls about cannabis.”

The CPCS doesn’t have records of how many calls lead to severe illness or death, but Heard agrees that the incidence of both for pot is zero. (It’s important to note that in all of these cases, cannabis included, there are likely considerably more actual cases of ingestion; the CPCS tracks only calls to poison control centers, most of them from households and some from emergency rooms or clinics seeking assistance. In many cases, people are brought to emergency rooms without anyone ever calling a poison center.)

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Besides kids finding edibles, newbies also generate poison control calls when they simply eat too much and get more high than they had expected.

A couple such cases have caught the media’s attention over the past few years. In 2016, 19 people, nearly all kids and teenagers, were treated after eating cannabis-infused gummies at a quinceañera party in San Francisco. And last year, a student at a middle school in Chula Vista sold gummies to some of his fellow students, who reporting becoming ill. In all cases, the victims were quickly treated and released.

Regulations Now Include Child-Proofing


Many edibles come in colorful packaging and are themselves colorful and enticing to both kids and adults. States that have legalized cannabis for adult use, including California, have laws in place governing packaging and marketing to make the products less attractive to children. Starting July 1, all legal cannabis product sold in California must come in child-resistant containers. But the main responsibility lies with the parents, Heard said. Which is not to say that both the government and industry can’t play their parts.

Heard compared the problem with cannabis products to the incidents a few years ago where kids were eating Tide Pods, concentrated laundry-detergent capsules that look like colorful candies.

“They were attractive to kids,” Heard said. “And what looked like a wonderful product all of a sudden wasn’t.”

Thousands of cases of poisonings were reported, and several people died.

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Manufacturer Proctor & Gamble made the product’s package opaque, added an ingredient to make the pods taste bitter, and added warning labels—all reasonable steps that have apparently mostly solved the problem.

Heard has no opinion on the legality of cannabis (or if he does, he won’t share it). But he says that when it comes to kids, cannabis “should be treated like any other product. You’ve got to keep it away from children.”

And while the number of “poison” calls is still small, Heard is concerned it will continue to grow, and he hopes that his and other officials’ publicity efforts will take hold. It’s important that parents and others become educated now, at the very beginning of legal pot sales in the state.

“Like Barney Fife used to say,” he said, “you’ve got to nip it—nip it in the bud.”


Greening Out

Poison Control’s Cannabis Advice

Heard at Poison Control described the typical cannabis-involved poison control call as coming from someone who is basically “having a panic attack of sorts.” The approach, he added, is usually to simply provide those people with “reassurance” that “the symptoms will likely improve with some time,” but to let them know they can always call their doctor or go to an urgent-care clinic or emergency room if they feel it’s necessary.

“We have seen this in individuals who used to smoke years ago, when the product was much less potent,” Heard said. With today’s far-higher levels of THC, those people often “are not expecting the response” they get from comparatively potent cannabis products.

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In the case of children, “we would refer them to the emergency room,” Heard said.

People who call with concerns that their pets have ingested cannabis products are referred to the ASPCA’s animal poison control center.

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